Individual provider Active NPI

Amanda Wilson, NP

  • Critical Care Medicine Nurse Practitioner
  • Bedford, IN
National Provider Identifier
1346137007
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
71017345A Issued in IN
Practice address
740 Pinewood Dr
Bedford, IN 47421-6657
Phone
(240) 577-3323
NPI assigned
Jun 23, 2025
Last updated
May 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 71017345A IN Primary

Addresses

Primary practice location

740 Pinewood Dr
Bedford, IN 47421-6657

Mailing address

740 Pinewood Dr
Bedford, IN 47421-6657
Phone (240) 577-3323

Other practice location 1

2672 E 2nd St
Bloomington, IN 47401-5371
Phone (812) 778-8080

Other names 1

  • Amanda Mullen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251105000313 IN Practitioner - Nurse Practitioner 1355831751 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Surgeons IncGroup PAC ID 9436171949, 126 clinicians
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (317) 944-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71017345AINMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Surgeons, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

7630 Solutions Ctr
Chicago, IL 60677

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1346137007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 PINEWOOD DR",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474216657",
            "telephone_number": "240-577-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 PINEWOOD DR",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474216657",
            "telephone_number": "240-577-3323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2672 E 2nd St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474015371",
            "country_code": "US",
            "telephone_number": "812-778-8080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AMANDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-23",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "IN",
            "license": "71017345A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MULLEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bedford, IN

Sources for this page

Verify at the official NPI Registry.